https://orcid.org/0000-0003-0462-4737
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ABSTRACT
Addressing substance use disorders and social determinants of poor health at a population level is a major national healthcare priority. One promising model to improve healthcare outcomes for patients with these conditions is the Vulnerable Veteran Innovative Patient-Aligned Care Team (PACT) Initiative, or VIP – an interdisciplinary, team-based primary care delivery model designed to address the needs of vulnerable patients in the Veterans Health Administration. VIP establishes a single, integrated primary care environment for the management of substance use disorders, mental illness, social determinants of poor health, and complexities in care resulting from the co-occurrence of these conditions. We describe the origination, goals, and evolution of VIP to provide an example of how clinics and health systems can address vulnerable patient populations within a primary care clinic framework. While ongoing evaluation will be essential to understand its impact on patient outcomes and its sustainability and scalability in the future, VIP holds promise as a novel model to improve care for patients with addiction and other vulnerabilities.
Acknowledgements
This material is based upon work supported by the U.S. Department of Veterans Affairs Veterans Integrated Service Network (VISN) 19; VA Salt Lake City Health Care System (VASLCHCS); the Vulnerable Veteran Innovative PACT (VIP) Initiative at the VASLCHCS; the Program for Addiction Research, Clinical Care, Knowledge, and Advocacy (PARCKA) at the University of Utah; and the VA Health Services Research and Development (HSR&D) Quality Enhancement Research Initiative (QUERI) Partnered Evaluation Initiative. Dr. Kelley’s efforts were supported by the VIP Initiative. Dr. Jones’ efforts were supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Numbers UL1TR002538 and KL2TR002539. Dr. Gordon’s efforts were supported by VA QUERI PEI 19-001 and NIH NIDA 1UG1DA04944-01. The authors wish to thank the leaders of the VASLCHCS and VISN 19 for their ongoing support of the VIP Initiative and thank Carrie Edlund for her editing of this manuscript. Supporting organizations had no further role in the study design; in the collection, analysis and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication. The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or any of its academic affiliates.
Author contributions
AJG obtained funding for the VIP Initiative. NC and AJG worked collaboratively on the first draft of the manuscript. ATK and AJ led the evaluation of the data. All authors, including MD, NV, AH, CG, TK, AB, SE, LJH, JP, and BZR, revised the manuscript for critical content and approved the final version of the manuscript.
Conflicts of interest
None of the authors of the manuscript have declared any conflicts of interest.
Financial disclosures
The authors report no conflicts of interest